Satow Takeshi, Aso Toshihiko, Nishida Sei, Komuro Taro, Ueno Tsukasa, Oishi Naoya, Nakagami Yukako, Odagiri Masashi, Kikuchi Takayuki, Yoshida Kazumichi, Ueda Keita, Kunieda Takeharu, Murai Toshiya, Miyamoto Susumu, Fukuyama Hidenao
Department of Neurosurgery, Nagahama City Hospital, Nagahama, Japan.
Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Front Aging Neurosci. 2017 Nov 23;9:387. doi: 10.3389/fnagi.2017.00387. eCollection 2017.
Idiopathic normal pressure hydrocephalus (iNPH) is a highly prevalent condition in the elderly population; however, the underlying pathophysiology in relation to the aging process remains unclear. To investigate the effect of removal of cerebrospinal fluid by lumbar "tap test" on the cerebral circulation in patients with iNPH, 14 patients with "probable" iNPH were studied using a novel blood tracking technique based on blood oxygenation level-dependent (BOLD) magnetic resonance signal intensity. By tracking the propagation of the low-frequency component of the BOLD signal, extended venous drainage times were observed in the periventricular region of the patients, which was reversed by tap test. Interestingly, the venous drainage time in the periventricular region exhibited an age-related prolongation in the healthy control group. Additional regression analyses involving 81 control subjects revealed a dissociation of deep and superficial venous systems with increasing age, presumably reflecting focal inefficiency in the deep system. Our results not only provide insights into the etiology of iNPH, but also point to a potential non-invasive biomarker for screening iNPH.
特发性正常压力脑积水（iNPH）在老年人群中是一种高度常见的病症；然而，与衰老过程相关的潜在病理生理学仍不清楚。为了研究通过腰椎“穿刺试验”抽取脑脊液对iNPH患者脑循环的影响，使用基于血氧水平依赖（BOLD）磁共振信号强度的新型血液追踪技术对14例“可能的”iNPH患者进行了研究。通过追踪BOLD信号低频成分的传播，在患者的脑室周围区域观察到静脉引流时间延长，而穿刺试验可使其逆转。有趣的是，在健康对照组中，脑室周围区域的静脉引流时间呈现出与年龄相关的延长。对81名对照受试者进行的额外回归分析显示，随着年龄增长，深静脉系统和浅静脉系统出现分离，这可能反映了深静脉系统局部效率低下。我们的结果不仅为iNPH的病因提供了见解，还指出了一种潜在的用于筛查iNPH的非侵入性生物标志物。
